Sarría Chueca A, Martín Nasarre de Letosa M T, Lomba García B, Moreno Aznar L A, Lázaro Almarza A, Bueno Sánchez M
Departamento de Pediatria, Hospital Clínico Universitario Lozano Blesa, Zaragoza.
An Esp Pediatr. 1997 Oct;47(4):357-62.
Diet, physical activity, physical fitness and body composition are factors that contribute to lipid disorders; however, we do not know whether they are relevant in children of the general population and in children with dyslipoproteinemias.
We have studied all of these factors in 89 children, aged 4.0 to 20.0 years. Children were divided into two groups: 1) Normocholesterolemics (total cholesterol < 225 mg/dL) and 2) Hypercholesterolemics (total cholesterol > or = 225 mg/dL).
In normocholesterolemic children, the main determinants of total and low-density lipoprotein cholesterol were height and cholesterol intake, which explained both 50 and 32% of its variability, respectively. The main determinants of high density lipoprotein cholesterol were blood pressure after submaximal loading and fat mass, which explained 50% of the variability. In hypercholesterolemic children, fat and carbohydrate intake and physical activity explained more than 90% of the variability of total and low density lipoprotein cholesterol. Resting energy expenditure explained 40% of the variability of high density lipoprotein cholesterol.
In the treatment of children and adolescents with dyslipoproteinemias, we must emphasize not only dietary intake, but also physical activity. To increase high density lipoprotein cholesterol we must also improve physical fitness and decrease the amount of body fat mass.
饮食、身体活动、体能和身体成分是导致脂质紊乱的因素；然而，我们尚不清楚它们在普通人群儿童和血脂蛋白异常儿童中是否相关。
我们对89名年龄在4.0至20.0岁的儿童的所有这些因素进行了研究。儿童被分为两组：1）正常胆固醇血症组（总胆固醇<225mg/dL）和2）高胆固醇血症组（总胆固醇≥225mg/dL）。
在正常胆固醇血症儿童中，总胆固醇和低密度脂蛋白胆固醇的主要决定因素是身高和胆固醇摄入量，分别解释了其变异性的50%和32%。高密度脂蛋白胆固醇的主要决定因素是次最大负荷后的血压和脂肪量，解释了50%的变异性。在高胆固醇血症儿童中，脂肪和碳水化合物摄入量以及身体活动解释了总胆固醇和低密度脂蛋白胆固醇变异性的90%以上。静息能量消耗解释了高密度脂蛋白胆固醇变异性的40%。
在治疗血脂蛋白异常的儿童和青少年时，我们不仅必须强调饮食摄入，还必须强调身体活动。为了提高高密度脂蛋白胆固醇水平，我们还必须改善体能并减少体脂肪量。
